Comparison of Resolute zotarolimus-eluting and Xience everolimus-eluting stents in patients with de novo long coronary artery lesions: a randomized LONG-DES VI trial.

Abstract

BACKGROUND:

Outcomes for stent-based coronary intervention of lesions with long diseased segments remain relatively unfavorable. This study sought to compare the efficacy of Resolute zotarolimus-eluting stents (R-ZES) and Xience everolimus-eluting stents (EES) for very long coronary lesions.

METHODS AND RESULTS:

This randomized, multicenter, prospective trial compared the use of R-ZES with EES for very long (≥50 mm) native coronary lesions. The primary end point was in-segment late luminal loss at 12-month angiographic follow-up. A total of 400 patients were needed to assess the primary end point. However, owing to very slow enrollment of patients, this trial was early terminated (302 patients were enrolled), and thus, this report provides descriptive information on primary and secondary end points. The R-ZES and EES groups had similar baseline characteristics. Lesion length was 49.6±10.2 and 50.6±13.3 mm in the R-ZES and EES groups, respectively (P=0.47). The number of stents used at the target lesion was 2.1±0.3 and 2.2±0.5, respectively. Twelve-month angiographic follow-up was performed in 50% of eligible patients. In-segment late luminal loss did not significantly differ between the R-ZES and EES groups (0.17±0.57 vs. 0.09±0.43 mm, P=0.32). In-segment binary restenosis rates were 8.1 and 5.3% in the R-ZES and EES groups, respectively (P=0.49). There were no significant between-group differences in the rate of adverse events (death, myocardial infarction, stent thrombosis, target lesion revascularization, and composite outcomes).

CONCLUSION:

For patients with very long native coronary artery disease, R-ZES and EES implantation showed comparable angiographic and clinical outcomes through 1 year of follow-up.

• Authors: Do-Yoon Kang, Cheol Hyun Lee, Pil Hyung Lee, Jung-Min Ahn, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Chang Wook Nam, Yun Seok Choi, Seung-Woon Rha, Jang Hyun Cho, Weon Kim, Sung-Ho Her, Myung Ho Jeong, Joo-Young Yang, Bong-Ki Lee, Hun Sik Park, Duk-Woo Park, Seung-Jung Park
• Journal: Coronary artery disease (Coron Artery Dis) Vol. 30 Issue 1 Pg. 59-66 (01 2019) ISSN: 1473-5830 [Electronic] England
• PMID: 30507632 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Immunosuppressive Agents
• Everolimus
• zotarolimus
• Sirolimus

Topics

• Aged
• Coronary Angiography
• Coronary Artery Disease (diagnosis, surgery)
• Coronary Vessels (diagnostic imaging, surgery)
• Drug-Eluting Stents
• Everolimus (pharmacology)
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (pharmacology)
• Male
• Percutaneous Coronary Intervention (methods)
• Prospective Studies
• Prosthesis Design
• Risk Factors
• Single-Blind Method
• Sirolimus (analogs & derivatives, pharmacology)
• Treatment Outcome